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At an international meeting a year and half ago, a professor of orthopaedic surgery from Europe approached me with an idea for some history papers that he wanted to publish in Clinical Orthopaedics and Related Research®. My initial reaction was guarded. CORR® does not publish history papers, and generally speaking, orthopaedic surgeons have about as much business dabbling in history as historians have with rotator cuffs. I gave the gentleman my card and invited him to send me the work when it was done, but I was not optimistic. I receive a fair number of proposals of this sort; most go nowhere.

A year later, I received a remarkable package: A set of compelling historical essays about the Nazi musculoskeletal experiments written by Dr. Erdem Bagatur, a professor of orthopaedic surgery in Istanbul, Turkey. The story he tells in these essays is one of terrible crimes committed by our professional forebears during my parents’ lifetimes. While Dr. Bagatur’s interest in this material is avocational—he is a university-based general orthopaedic surgeon—his handling of it is passionate and professional. He spent 3 years on the project, having made 11 trips to city and national archives in Germany and Austria, where he reviewed thousands of primary-source documents, and evaluated filmed testimony as well as the transcripts from the Nazi Doctors’ Trial of 1946-1947. Even in draft form, the writing was wonderful—and in the author’s second language, no less.

But I remained uneasy. This journal's main mission is original musculoskeletal research; why should we publish a pair of historical essays? Certainly, this is not a business CORR can or should sustain over the longer run. And if we publish this work, how might we ensure that it meets appropriate standards of historical scholarship and ethical balance? After all, there may still be living stakeholders, relatives of the individuals pictured in the photographs Dr. Bagatur used to illustrate his work [1].

Suffice it to say that this Journal will not adjust its mission to dabble in history. I believe that publishing Dr. Bagatur’s essays (the first of which appears in this month’s CORR [1], with the second to follow next month) sets no precedent in that regard, since the Nazi musculoskeletal experiments truly are sui generis. The 20th century saw more than its share of horrors, but this is the only example in which our professional forebears—all educated, and highly literate—committed industrial-scale, egregious crimes while wearing white coats and representing our specialty. That it happened in the country of Einstein, Schoenberg, and van der Rohe when they were at the height of their generative powers suggests it can happen anywhere, anytime.

We have heard that before, of course, and while we may wish to believe it isn’t so, recent international events suggest it certainly is. This is a large part of why I decided to move ahead with Dr. Bagatur’s unusual work. Nativism and virulent anti-Semitism are on the march once again not just in Germany [2, 5] but also elsewhere in Europe [4]. And in the United States, where racists and anti-Semites used to wear hoods, they now show their faces, shouting “Jews will not replace us” on the campus of one leading university [6] and recruiting on others [3]. People again are giving voice to evil ideas that once were and still should be considered shameful. These facts, along with 2018 marking the 70th anniversary of the deaths of those executed following the Nazi Doctors’ Trial, together answer the question “why publish this now?”

But I am neither a historian nor an ethicist, and so I needed and obtained considerable outside help in order to handle this important material properly. To confirm that Dr. Bagatur’s work [1] engages with relevant sources and meets the highest standards of historical scholarship, I shared it with historians of the Holocaust at Oxford (Paul Weindling PhD) and Harvard Universities (Kevin J. Madigan PhD); they assured me that it does. To ensure that potential stakeholders have been treated fairly and confirm that the benefits of publishing Dr. Bagatur’s essay outweigh any potential harms, I visited at length with the chair of the Department of Bioethics and Humanities at the University of Washington, Denise M. Dudzinski PhD. I shared with Dr. Dudzinski my own conflict of interest on this topic, which I also share here: I am Jewish, and a large portion of my mother’s family was murdered by the Nazis during the Holocaust. Of those then living in Europe, only one of her cousins managed to escape. Despite potential ethical concerns about the photographs that accompany Dr. Bagatur’s essay, and despite my own relationship to this sad story, Dr. Dudzinski felt strongly that CORR’s readership should—indeed, must—see this material. I agree.

Acknowledgment

I am deeply indebted to Professor Paul Weindling (Oxford Brookes University), Professor Kevin J. Madigan (Harvard University), and Professor Denise M. Dudzinski (University of Washington) for their evaluation of and comments about Dr. Bagatur’s column [1] and for guiding my thinking about how to handle content of this sort in a surgical journal.

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